GOITER & GOITROGENS IN FOOD

Iodine is an essential micro nutrient for all animal species & iodine deficiency is among the most prevalent nutritional problem in many developing countries.

In 1928 Chesney & his colleagues at Johns Hopkin Hospital made the chance observation that rabbits rose in the laboratory for the study of Syphilis & fed largely on Cabbage developed Goiter .This observation was followed up by Charles Hercus & his colleague in New Zealand .They established the goitrogenic properties of Cabbage, Turnip & particularly the seeds of Cabbage, Mustard & Rye. A large number of food stuffs possess anti-thyroid agents collectively designated as Goitrogens.

Depending upon the level of interference the goitrogens have been categorized into three classes.

CLASS 1 GOITROGENS:

Are those which inhibit the Iodine uptake by Thyroid gland.These are Thiocynate, Isothiocynate & cyanogenic glucosides.

CLASS 2 GOITROGENS:

Are those which affect the stages of Organification & coupling in the process of Thyroxin synthesis.These are Thiourea & Flavonoides.

CLASS 3 GOITROGENS:

Are those which interfere at the stage of Proteolysis-a step necessary for utilization of Thyroxine.These are Iodine itself when it is in excess & lithium.


In Sudan endemic Goiter & Iodine deficiency disorders are serious health problems.In these areas Iodine deficiency was identified as the principal etiologic factor. However consumption of Pearl Millet ( Bajra) was suggested as an instrumental factor in the etiology of Endemic Goiter in Western Sudan. Pearl millet or Bajra is the main source of food energy for the rural people in many areas of semiarid tropics. Studies showed that the goitrogenic substance was present in both bran & endosperm portions of the grain & was not destroyed by grain fermentation however autoclaving reduced the goitrogeic properties of Pearl Millet.The Goitrogenic substances present in Pearl Millet are Glycosyl Vitexin, Glycosyl Orientin & Vitexin.

Sorghum ( Jowar ) like Pearl Millet ( Bajra ) also contains goitrogenic substance .The goitrogen in Sorghum is known as Dhurin. Cassava is cultivated extensively in developing countries & represents an essential dietary source of energy for more than 200 million people in the tropics.Casava has been demonstrated in the etiology of endemic Goiter & endemic Cretinism in Zaire.Casava contained Linamarin which is groitrogenic substance.The proper processing of Cassava-drying , soaking in water , rinsing or baking effectively reduces Cassava’s Linamarin content. Vegetables from Cruciferae family like Cabbage , Broccoli , Turnip etc also contain goitrogens.However with heating they get destroyed. Soya bean even the processed ones have anti thyroid properties. Genistein & Daizein are much touted for their health benefits but what is unpublicized is they are anti-thyroid agents.Therefore individuals who consume Soyabean products habitually may encounter thyroid disturbances.

Thus foods containing goitrogens should not be eaten regularly or in large amounts without adequate processing .However the same foods can be used in the treatment of hyperthyroidism.

BLOOD PRESSURE & HYPERTENSION

Classification of Blood Pressure for adults :

CATEGORY SYSTOLIC / DIASTOLIC



Optimal < 120 mmHg / <80 mmHg


Normal <130 mmHg / < 85 mmHg


High Normal 130-139 mmHg / 85-89mmHg
(are at a risk )


Mild Hypertension 140-159 mmHg / 90-99 mmHg


Moderate Hypertension 160-179 mmHg / 100-109 mmHg


Severe Hypertension 180-209 mmHg / 110-119 mmHg


Very Severe Hypertension >210 mmHg / >120 mmHg

CAUSES OF DENTAL CARIES

TEETH ARE LIKE WIVES WHEN THEY ARE THEIR WE FIGHT WITH THEM & WHEN WE LOSE THEM WE CRY. THIS IS AN OLD SAYING. A major reason due to which we lose teeth is dental caries. In order to protect them from decay we should first know what causes decay.

1) ACID REFLUX DISORDERS :
Both gastric reflux & self induced vomiting observed in eating disorders commonly irritate oral tissue & destroy dental enamel. The extent of oral tissue damage depends on the frequency of the purging & cariogenicity of the diet. The most obvious symptom of bulimia is loss of tooth enamel because of frequent self induced vomiting.


2) LACK OF SALIVARY FLOW :
Saliva has anti bacterial & neutralizing properties. These two properties are of significance as caries is a disease where bacteria &acids are involved. The average amount of salivary secretions in 24 hours is roughly estimates as 1& ½ lts .The flow is not steady in an individual as rate of secretion is influenced by various factors. The condition of dryness of mouth called XEROSTOMIA may be caused by number of diseases that interrupt the secretary nerve pathway. A regular flow of saliva aids in bringing down the caries rate. Individuals who have to undergo radiation of the parotid salivary gland of left side develop more caries on the left side because of decreases salivary flow in left side.


3) MEDICATIONS USED:
Several categories of medications can affect the integrity of the oral mucosa, taste, sensation & salivary production. Care should be taken to assess the effects of medications in the oral cavity & how these effects can be minimized by alterations in diet or during therapy. The following medications affect teeth

- Anti anxiety agents

- Anti depressants

- Anti histamines

- Anti hypertensives

- Diuretics

- Sedatives

- Tranquilizers

4) NUTRITIONAL DEFICIENCY:
Nutrition plays a significant part in the caries incidence. Deficiency of Vitamin A, C, D & proteins in infants & children result in their teeth being more vulnerable to decay than those of others. Lady Mallenby, the famous British dental researcher who studied the nutritional aspect of dental caries for over 30 years demonstrated that adequate supplements of Vitamins, Calcium & Phosphorus to diets brought an appreciable drop in caries incidence.


5) SOFT FOOD :
Today's finely powdered flour without a trace of husk harms the teeth of people as food made from refines flour needs no chewing & it rapidly forms into a sticky mass that adheres to the teeth .